{
"Npi": {
"NPI": "1629566500",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KENTUCKY CHRISTIAN RECOVERY, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1118 S. MAIN ST.",
"SecondLineMailingAddress": "SUITE 3",
"MailingAddressCityName": "MORGANTOWN",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42261",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-288-5058",
"MailingAddressFaxNumber": "270-288-5080",
"FirstLinePracticeLocationAddress": "1118 S. MAIN ST.",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "MORGANTOWN",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42261",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-288-5058",
"PracticeLocationAddressFaxNumber": "270-288-5080",
"EnumerationDate": "04/26/2018",
"LastUpdateDate": "04/26/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEST",
"AuthorizedOfficialFirstName": "BENJAMIN",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "OWNER/EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPCC",
"AuthorizedOfficialTelephoneNumber": "270-799-1658",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "324500000X",
"TaxonomyName": "Substance Abuse Rehabilitation Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}